NPIMap

Individual provider Active NPI

Meesha B Gwan-Nulla, MD

  • Internal Medicine Physician
  • Columbus, GA
National Provider Identifier
1669435707
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
081189 Issued in GA
Practice address
2737 Warm Springs Rd BLDG BC
Columbus, GA 31904-6859
Phone
(706) 653-2255
Fax
(706) 653-2329
NPI assigned
Apr 10, 2006
Last updated
Oct 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2015-01372 NC
Internal Medicine Physician 207R00000X 2009028452 MO
Internal Medicine Physician 207R00000X MD064633L PA
Internal Medicine Physician 207R00000X 081189 GA Primary

Addresses

Primary practice location

2737 Warm Springs Rd BLDG BC
Columbus, GA 31904-6859

Mailing address

16 Physician Dr
Clyde, NC 28721-8486
Phone (828) 456-9836

Other practice location 1

16 Physician Dr
Clyde, NC 28721-8486
Phone (828) 456-9836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181009003326 GA Practitioner - Internal Medicine 2163482068 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of Ny Upstate Medical University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2737 Warm Springs Rd
Suite B and C
Columbus, GA 31904-5328
Phone (706) 653-2255

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2015-01372NCMDInternal Medicine Physician
MD064633LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Ambulatory Healthcare Services, Inc. CurrentSince Oct 1, 2018 Accepting new patients
Columbus Ambulatory Healthcare Services, Inc. Internal Medicine CurrentSince Oct 1, 2018 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Conemaugh Health Initiatives Past Accepting new patients
Columbus Ambulatory Healthcare Services, Inc. Past Accepting new patients

Locations

1800 10th Ave
Columbus, GA 31901
Phone (706) 571-1120

2737 Warm Springs Rd
Bldg Bc
Columbus, GA 31904
Phone (706) 653-2255

2737 Warm Springs Rd
Ste B
Columbus, GA 31904
Phone (706) 576-5149

2737 Warm Springs Rd
Ste C
Columbus, GA 31904
Phone (706) 571-1136

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1669435707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 PHYSICIAN DR",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287218486",
            "telephone_number": "828-456-9836",
            "fax_number": "828-452-9814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2737 WARM SPRINGS RD BLDG BC",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046859",
            "telephone_number": "706-653-2255",
            "fax_number": "706-653-2329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 Physician Dr",
            "address_purpose": "LOCATION",
            "city": "Clyde",
            "state": "NC",
            "postal_code": "287218486",
            "country_code": "US",
            "telephone_number": "828-456-9836",
            "fax_number": "828-452-9814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GWAN-NULLA",
        "first_name": "MEESHA",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2015-01372",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2009028452",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD064633L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "081189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.